Document Type

Article

Publication Date

2026

DOI

10.1111/jch.70216

Publication Title

Journal of Clinical Hypertension

Volume

28

Issue

2

Pages

e70216 (1-12)

Abstract

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear models were used to estimate adjusted prevalence ratios (PRs), accounting for age, sex, race and ethnicity, family income-to-poverty threshold ratio, and study period, with interaction terms to assess differential temporal trends. Among 61,847 participants (51.7% women; 21.0% Black; 25.1% Hispanic; 23.2% aged >65 years), adjusted hypertension prevalence was 44.3% (95% CI: 43.6-44.9) and remained stable over time (p for trend = 0.50). Relative to >65 years adults, hypertension prevalence increased significantly over time among the younger groups. Compared to White adults, Black adults had higher hypertension prevalence (52.7% vs 44.7%; p < 0.001), and Hispanic adults experienced a greater increase in prevalence over time. Among individuals with hypertension, undiagnosed hypertension declined from 46.4% to 41.5%, and on-treatment uncontrolled hypertension declined from 74.7% to 63.9% (both p < 0.001). Despite improvements in diagnosis and treatment control, hypertension prevalence remains high, with persistent sociodemographic disparities highlighting the need for targeted and equity-focused interventions.

Rights

© 2026 The Authors.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modification or adaptations are made.

Original Publication Citation

Saleh, O., Rehan, N., Mostafa, S., & Qayyum, R. (2026). Trends in hypertension prevalence and control in the United States over 25 years. Journal of Clinical Hypertension, 28(2), 1-12, Article e70216. https://doi.org/10.1111/jch.70216

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